What is the consistency between clinical and pathological staging in tongue cancer?

What is the consistency between clinical and pathological staging in tongue cancer?

Objectives: This study aimed to evaluate the consistency between clinical and pathological staging in tongue cancer.Patients and Methods: We retrospectively evaluated 33 patients (24 male, 9 female; mean age 56±13 years; range, 31-87 years)who were admitted to the Şişli Hamidiye Etfal Training and Research Hospital Otorhinolaryngology Head and Neck Surgery Clinicand operated on for tongue cancer. The clinical stages were determined with physical examination and radiological findings. Theconsistency of the clinical stages with pathological stages was evaluated with Mc Nemar Analysis and Kappa test.Results: For tumor (T) stage, the clinical and pathological stage estimate was 60.6% compatible whereas for cervical lymph node(N) stage it was 54.5%. There was poor agreement between clinical and pathological stages.Conclusion: In order to make more accurate clinical staging and to overcome poor agreement between clinical and pathologicalstaging, more detailed and additional radiological imaging with a comprehensive physical examination are required. Routinepreoperative positron emission tomography scanning and radiological examination of the tumor by an expert head and neckradiologist and evaluation by a pathologist experienced in head and neck malignancies is recommended.

___

  • 1. Alvi A, Myers EN, Johnson JT. Cancer of the oral cavity. In: Myers EN, Suen JY, editors. Cancer of the Head and Neck. 3rd ed. Philadelphia: W.B. Saunders; 1996. p. 321-61.
  • 2. Edge S, Byrd DR, Compton CC. Pharynx. In: Edge SB, Byrd DR, Compton CC, editors. AJCC Cancer Staging Manual. 7th ed. New York: Springer; 2010. p. 41-56.
  • 3. Lydiatt WM, Patel SG, O’Sullivan B, Brandwein MS, Ridge JA, Migliacci JC, et al. Head and Neck cancersmajor changes in the American Joint Committee on cancer eighth edition cancer staging manual. CA Cancer J Clin 2017;67:122-37.
  • 4. Shingaki S, Takada M, Sasai K, Bibi R, Kobayashi T, Nomura T, et al. Impact of lymph node metastasis on the pattern of failure and survival in oral carcinomas. Am J Surg 2003;185:278-84.
  • 5. Otsuru M, Aoki T, Ota Y, Denda Y, Akiba T, Sekine R, et al. Is an Elective Neck Dissection Necessary for All Cases of N0 Oral Squamous Cell Carcinoma? -Elective Neck Dissection may be Performed for Tongue Cancer with Tumor Thickness More than 4 mm. Tokai J Exp Clin Med 2016;41:112-7.
  • 6. Cariati P, Cabello Serrano A, Fernandez Solis J, Martinez Lara I. Distribution of cervical metastasis in tongue cancer: Are occult metastases predictable? A retrospective study of 117 oral tongue carcinomas. J Craniomaxillofac Surg 2018;46:155-61.
  • 7. Fukano H, Matsuura H, Hasegawa Y, Nakamura S. Depth of invasion as a predictive factor for cervical lymph node metastasis in tongue carcinoma. Head Neck 1997;19:205-10.
  • 8. Almangush A, Bello IO, Keski-Säntti H, Mäkinen LK, Kauppila JH, Pukkila M, et al. Depth of invasion, tumor budding, and worst pattern of invasion: prognostic indicators in early-stage oral tongue cancer. Head Neck 2014;36:811-8.
  • 9. Haksever M. Oral Kavite Kanserlerinde Evreleme, Prognostik Faktörler ve Evreleme Sistemi Üzerine Değerlendirmeler Kocatepe Tıp Dergisi 2013;14:109-17.
  • 10. Goel R, Moore W, Sumer B, Khan S, Sher D, Subramaniam RM. Clinical practice in PET/CT for the management of head and neck squamous cell cancer. AJR Am J Roentgenol 2017;209:289-303.
  • 11. Sun R, Tang X, Yang Y, Zhang C. (18)FDG-PET/CT for the detection of regional nodal metastasis in patients with head and neck cancer: a meta-analysis. Oral Oncol 2015;51:314-20.
  • 12. Weiss MH, Harrison LB, Isaacs RS. Use of decision analysis in planning a management strategy for the stage N0 neck. Arch Otolaryngol Head Neck Surg 1994;120:699-702.
  • 13. Arya S, Rane P, Deshmukh A. Oral cavity squamous cell carcinoma: role of pretreatment imaging and its influence on management. Clin Radiol 2014;69:916-30.
  • 14. Navarro CS, Saez AD, Santabaya AH. Diagnostic value of mri in measurement of tumor thickness in tongue cancer: a comparative study according to tumor location. Int JOral Maxillofac Surg. 2013;42:1281.
  • 15. Baba A, Ojiri H, Ikeda K, Yamauchi H, Ogino N, Seto 3, et al. Essentials on oncological imaging: postoperative computed tomography and magnetic resonance imaging of oral tongue cancer. Can Assoc Radiol J 2018;69:458-67.
  • 16. Afzali P, Ward BB. Management of the neck in oral squamous cell carcinoma: background, classification, and current philosophy. Oral Maxillofac Surg Clin North Am 2019;31:69-84.